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Effect of transcranial direct current stimulation on cognitive function in tobacco smokers: a preliminary study
Abstracts / Brain Stimulation 10 (2017) 346e540
[0790] DEEP BRAIN STIMULATION FOR TREATMENT RESISTANT DEPRESSION: CHALLENGES IN RECRUITMENT K. Williams, S. Golding, A. Mackie, G. Ramasubbu*. University of Calgary, Canada
MacQueen,
Z.
Kiss,
533
Conclusion: Overall, these findings suggest that tDCS over the DLPFC may be improved cognitive function in tobacco smoker subject. Keywords: transcranial direct current stimulation, cognitive function, Addiction, Tobago
R.
Introduction: Deep Brain Stimulation (DBS) is an investigational treatment for treatment resistant depression (TRD). Recruitment for DBS trials remains challenging due to unproven efficacy in sham controlled DBS trials, invasive nature of the intervention and stringent eligibility criteria in patients’ selection. In this study we examined the referral patterns and exclusion causes of a DBS trial to improve our knowledge on DBS candidacy in TRD. Methods: The data was collected from all patients who expressed interest in participating in a DBS study involving subcallosal cingulate region from 2014-2016. Referral sources were categorized as self or professional referrals. The evaluation for eligibility was done in three stages; initial contact, brief assessment over phone, and in-person psychiatric evaluation by psychiatrists. The patient selection was classified as those excluded and included for DBS surgery and exclusion causes were documented. Data were analyzed using descriptive and frequency distribution. Results: Among 225 patients who contacted initially, only 22 (9.2%) underwent DBS surgery. Majority of patients were excluded because of self-withdrawal (38.42%) and due to residence outside the province or country (26.11%). Psychiatric/ medical comorbidity was the common cause of exclusion based on selection criterion compared to other causes (inadequate treatment/ less severe resistance and overage) (21.67% vs 13.3, P¼0.007). Self-referral was higher than the referral from professionals (75% vs 25%, P<0.0001) and acceptance rate for surgery was higher among the professional referrals than from self-referrals (40% vs 15%, P¼0.03). Discussion: Our findings suggest the need for specific recruitment strategies to improve the quality of self- referral and volume of professional referral. The higher percentage of co-morbidity exclusion cause underlines the importance of careful screening in the selection of candidates for DBS trials. The data based insights into recruitment will help to increase the enrollment thereby enhancing the feasibility and validity of future DBS trials. Keywords: Deep Brain Stimulation, Subcallosal cingulate, Treatment Resistant Depression, Recruitment
[0791] EFFECT OF TRANSCRANIAL DIRECT CURRENT STIMULATION ON COGNITIVE FUNCTION IN TOBACCO SMOKERS: A PRELIMINARY STUDY A. Alatawi*, A. Alhussien, T. Almusned, M. Alohali, F. Alghamdi, S. Habib, S. Bashir. King Saud University, Saudi Arabia Objectives: Transcranial direct current stimulation (tDCS) is a neuromodulation tool have been used widely in many medical/experimental trails. We aim to assess the effect of the tDCS over the dorsolateral prefrontal cortex (DLPFC) on cognitive function in tobacco smoker. Methods: In this double-blinded experiment, 22 human subjects (male) were randomized into two groups: active (n¼12), and sham(n¼10) in order to investigate the effect of (tDCS) on cognitive function. A 20-minutes stimulation over Dorsolateral prefrontal cortex (DLPFC) for three consecutive days with a current of 1.5 mA was delivered by tDCS. The cognitive functions outcome variables were the response time (Attention switching task (AST), Complex Reaction time (CRT) task) and the percentage of correct answers (pattern recognition memory (PRM) task). Cognitive functions were assessed by using Cambridge Neuropsychological Automated Battery (CANTAB). Results: Comparing the results for CANTAB test, Attention Switching Task (AST) showed a significance improvement after stimulation in mean correct latency, mean correct latency (congruent) and mean correct latency (incongruent) for active group (p-value¼0.003, 0.004 and 0.005) and sham (p-value¼ 0.003, 0.004 and 0.003) respectively. But there was not significant effect in Pattern recognition Memory (PRM) between pre and post stimulation in both groups (p¼ 0.477 and p¼0.677)
[0792] OPEN LABEL TRIAL OF RTMS FOR TREATMENT RESISTANT DEPRESSION IN YOUTH Q. McLellan, A. Kirton, C. Kahl*, Y. Jasaui, C. Wilkes, R. Swansburg, E. Zewdie, F.P. MacMaster. University of Calgary, Canada Introduction: The incidence of major depressive disorder (MDD) in adolescents is a growing concern. Repetitive transcranial magnetic stimulation (rTMS) is an emerging intervention for treatment-resistant MDD in adolescents. We investigated imaging biomarkers associated with treatment response. We hypothesized that lower baseline glutamate levels would predict beneficial rTMS treatment response and associate with lower MDD scores post-treatment. Methods: 29 youth diagnosed and previously treated for MDD were recruited. Anatomical, diffusion tensor imaging, cerebral blood flow, resting state fMRI, and spectroscopy data were collected on a 3.0T GE MR750w. Magnetic resonance imaging (MRI) and questionnaires were conducted both before and after the 15-weekday treatment which applied rTMS to the left dorsolateral prefrontal cortex (DLPFC). The participants, MRI, and TMS coil were co-registered for precise DLPFC targeting. Treatment consisted of 3000 high frequency (10 Hz) rTMS stimulations to the DLPFC at 120% RMT; response was defined as a 50% reduction of Hamilton depression rating scores (HAM-D). Results: At baseline, responders had lower left DLPFC glutamate concentration (p¼0.047), which increased with rTMS compared to non-responders (p¼0.01) and correlated with the change in HAM-D scores (r¼0.58, p¼0.02). Reduced DLPFC thickness was observed in responders (p¼0.009), and was also associated with greater change in HAM-D (r¼0.56, p¼0.03). Lower left DLPFC cerebral blood flow at baseline was associated with greater change in Children’s Depression Rating Scale (CDRS) (r¼-0.62, p¼0.02) and Beck Depression Inventory (BDI) scores (r¼-0.59, p¼0.03). Clinical scores decreased with rTMS (CDRS: t(28)¼7.512, p<0.001; HAM-A: t(28)¼7.863, p<0.001; HAM-D: t(28)¼8.765, p<0.001; BDI: t(28)¼6.584, p<0.001). Finally, baseline resting state activity of the DLPFC inversely correlated with subgenual cortex activity in responders but not non-responders. No significant adverse events were reported. Discussion: DLPFC glutamate, cortical thickness, and resting state connectivity may help identify both physiological mechanisms and clinical responsiveness in rTMS treatment of adolescent depression. Keywords: TMS, Depression, Pediatrics, Neuroimaging
[0793] THE ROLE OF PREMOTOR CORTEX IN ACTION MONITORING: A TRANSCRANIAL MAGNETIC STIMULATION STUDY A. Salatino*, A. Piedimonte, P. Sarasso, F. Garbarini, R. Ricci, A. Berti. University of Turin, Italy A key challenge for cognitive neuroscience is the understanding of the conscious and unconscious mechanisms underlying the construction of willed actions. Although the Premotor Cortex (PMC) has been previously described as involved in action monitoring (Berti et al., 2005), its precise role in the construction of motor awareness (MA) is still under investigation. In the present study, we investigated the role of the PMC in MA in thirteen healthy participants using low-frequency rTMS. We used a motor task in which participants were instructed to trace straight lines to a given target with the hand hidden under a box. Participants received a visual feedback on a computer screen. In 96% of the trials, the lines shown on the screen were deviated either to the right or to the left of the actual
[0790] DEEP BRAIN STIMULATION FOR TREATMENT RESISTANT DEPRESSION: CHALLENGES IN RECRUITMENT K. Williams, S. Golding, A. Mackie, G. Ramasubbu*. University of Calgary, Canada
MacQueen,
Z.
Kiss,
533
Conclusion: Overall, these findings suggest that tDCS over the DLPFC may be improved cognitive function in tobacco smoker subject. Keywords: transcranial direct current stimulation, cognitive function, Addiction, Tobago
R.
Introduction: Deep Brain Stimulation (DBS) is an investigational treatment for treatment resistant depression (TRD). Recruitment for DBS trials remains challenging due to unproven efficacy in sham controlled DBS trials, invasive nature of the intervention and stringent eligibility criteria in patients’ selection. In this study we examined the referral patterns and exclusion causes of a DBS trial to improve our knowledge on DBS candidacy in TRD. Methods: The data was collected from all patients who expressed interest in participating in a DBS study involving subcallosal cingulate region from 2014-2016. Referral sources were categorized as self or professional referrals. The evaluation for eligibility was done in three stages; initial contact, brief assessment over phone, and in-person psychiatric evaluation by psychiatrists. The patient selection was classified as those excluded and included for DBS surgery and exclusion causes were documented. Data were analyzed using descriptive and frequency distribution. Results: Among 225 patients who contacted initially, only 22 (9.2%) underwent DBS surgery. Majority of patients were excluded because of self-withdrawal (38.42%) and due to residence outside the province or country (26.11%). Psychiatric/ medical comorbidity was the common cause of exclusion based on selection criterion compared to other causes (inadequate treatment/ less severe resistance and overage) (21.67% vs 13.3, P¼0.007). Self-referral was higher than the referral from professionals (75% vs 25%, P<0.0001) and acceptance rate for surgery was higher among the professional referrals than from self-referrals (40% vs 15%, P¼0.03). Discussion: Our findings suggest the need for specific recruitment strategies to improve the quality of self- referral and volume of professional referral. The higher percentage of co-morbidity exclusion cause underlines the importance of careful screening in the selection of candidates for DBS trials. The data based insights into recruitment will help to increase the enrollment thereby enhancing the feasibility and validity of future DBS trials. Keywords: Deep Brain Stimulation, Subcallosal cingulate, Treatment Resistant Depression, Recruitment
[0791] EFFECT OF TRANSCRANIAL DIRECT CURRENT STIMULATION ON COGNITIVE FUNCTION IN TOBACCO SMOKERS: A PRELIMINARY STUDY A. Alatawi*, A. Alhussien, T. Almusned, M. Alohali, F. Alghamdi, S. Habib, S. Bashir. King Saud University, Saudi Arabia Objectives: Transcranial direct current stimulation (tDCS) is a neuromodulation tool have been used widely in many medical/experimental trails. We aim to assess the effect of the tDCS over the dorsolateral prefrontal cortex (DLPFC) on cognitive function in tobacco smoker. Methods: In this double-blinded experiment, 22 human subjects (male) were randomized into two groups: active (n¼12), and sham(n¼10) in order to investigate the effect of (tDCS) on cognitive function. A 20-minutes stimulation over Dorsolateral prefrontal cortex (DLPFC) for three consecutive days with a current of 1.5 mA was delivered by tDCS. The cognitive functions outcome variables were the response time (Attention switching task (AST), Complex Reaction time (CRT) task) and the percentage of correct answers (pattern recognition memory (PRM) task). Cognitive functions were assessed by using Cambridge Neuropsychological Automated Battery (CANTAB). Results: Comparing the results for CANTAB test, Attention Switching Task (AST) showed a significance improvement after stimulation in mean correct latency, mean correct latency (congruent) and mean correct latency (incongruent) for active group (p-value¼0.003, 0.004 and 0.005) and sham (p-value¼ 0.003, 0.004 and 0.003) respectively. But there was not significant effect in Pattern recognition Memory (PRM) between pre and post stimulation in both groups (p¼ 0.477 and p¼0.677)
[0792] OPEN LABEL TRIAL OF RTMS FOR TREATMENT RESISTANT DEPRESSION IN YOUTH Q. McLellan, A. Kirton, C. Kahl*, Y. Jasaui, C. Wilkes, R. Swansburg, E. Zewdie, F.P. MacMaster. University of Calgary, Canada Introduction: The incidence of major depressive disorder (MDD) in adolescents is a growing concern. Repetitive transcranial magnetic stimulation (rTMS) is an emerging intervention for treatment-resistant MDD in adolescents. We investigated imaging biomarkers associated with treatment response. We hypothesized that lower baseline glutamate levels would predict beneficial rTMS treatment response and associate with lower MDD scores post-treatment. Methods: 29 youth diagnosed and previously treated for MDD were recruited. Anatomical, diffusion tensor imaging, cerebral blood flow, resting state fMRI, and spectroscopy data were collected on a 3.0T GE MR750w. Magnetic resonance imaging (MRI) and questionnaires were conducted both before and after the 15-weekday treatment which applied rTMS to the left dorsolateral prefrontal cortex (DLPFC). The participants, MRI, and TMS coil were co-registered for precise DLPFC targeting. Treatment consisted of 3000 high frequency (10 Hz) rTMS stimulations to the DLPFC at 120% RMT; response was defined as a 50% reduction of Hamilton depression rating scores (HAM-D). Results: At baseline, responders had lower left DLPFC glutamate concentration (p¼0.047), which increased with rTMS compared to non-responders (p¼0.01) and correlated with the change in HAM-D scores (r¼0.58, p¼0.02). Reduced DLPFC thickness was observed in responders (p¼0.009), and was also associated with greater change in HAM-D (r¼0.56, p¼0.03). Lower left DLPFC cerebral blood flow at baseline was associated with greater change in Children’s Depression Rating Scale (CDRS) (r¼-0.62, p¼0.02) and Beck Depression Inventory (BDI) scores (r¼-0.59, p¼0.03). Clinical scores decreased with rTMS (CDRS: t(28)¼7.512, p<0.001; HAM-A: t(28)¼7.863, p<0.001; HAM-D: t(28)¼8.765, p<0.001; BDI: t(28)¼6.584, p<0.001). Finally, baseline resting state activity of the DLPFC inversely correlated with subgenual cortex activity in responders but not non-responders. No significant adverse events were reported. Discussion: DLPFC glutamate, cortical thickness, and resting state connectivity may help identify both physiological mechanisms and clinical responsiveness in rTMS treatment of adolescent depression. Keywords: TMS, Depression, Pediatrics, Neuroimaging
[0793] THE ROLE OF PREMOTOR CORTEX IN ACTION MONITORING: A TRANSCRANIAL MAGNETIC STIMULATION STUDY A. Salatino*, A. Piedimonte, P. Sarasso, F. Garbarini, R. Ricci, A. Berti. University of Turin, Italy A key challenge for cognitive neuroscience is the understanding of the conscious and unconscious mechanisms underlying the construction of willed actions. Although the Premotor Cortex (PMC) has been previously described as involved in action monitoring (Berti et al., 2005), its precise role in the construction of motor awareness (MA) is still under investigation. In the present study, we investigated the role of the PMC in MA in thirteen healthy participants using low-frequency rTMS. We used a motor task in which participants were instructed to trace straight lines to a given target with the hand hidden under a box. Participants received a visual feedback on a computer screen. In 96% of the trials, the lines shown on the screen were deviated either to the right or to the left of the actual